MSC CRUISES | SPECIAL REQUIREMENTS INFORMATION (MSC Cruises Fax 908.605.2600 | Phone: 954.772.6262)

Should you have Special Requirements, please review and complete this form. MSC Cruises will seek to the extent feasible to accommodate all requests. This information is necessary so that we are aware of any special requirements you have and may be provided to third parties, as needed.
*First Name:  
Middle Name:
*Last Name:  
Date Submitted:  
My Travel Agent is:
Agency Phone Number:
Agency Address:
Ship Name:
Please describe any condition, illness, equipment or facilities that require special assistance as well as any special equipment you need (e.g. hypodermic disposal bin or facilities to refrigerate medicine)2:
I will be traveling with someone who will provide me with the assistance I require (choose one):

If Yes, Relationship (please specify):

I am bringing a service animal with me3 (choose one):
If Yes, Type of Animal (please specify):

I require the use of oxygen (choose one):

For Passengers With Mobility Impairments: (check the appropriate box)

I will bring a wheelchair5:
If Yes, Please Specify Following shown below:

Type of wheelchair:

Wheelchair/Scooter Weight (lbs):

Wheelchair/Scooter Width (inches):

Wheelchair/Scooter Height (inches):

My Weight is (lbs):

I can step up onto a bus:
I need hydraulic lift equipment for transportation for tour or transfer:
For Passengers With Diabetes: (check the appropriate box)
My diabetes is controlled through:
I require access to refrigerated medicine:
I require access to refrigerated medicine every (specify hours):
I need Hypodermic Disposal Facilities:
Deaf/Hard of Hearing: (check the appropriate box)

For MSC Cruises Use Only
Cruise Begins:
Cruise Ends:
1 MSC's brochure indicates transfers are included with MSC packages. You may purchase transfers by contacting MSC Cruises at 800.666.9333.
2 Guests undergoing CAPD (Peritoneal Dialysis) must arrange for delivery of their own solutions and supplies to the vessel.
3 Service animals must have all required immunizations and paperwork.
4 The ship has oxygen for emergency use only. Guests requiring oxygen can make independent arrangements for their oxygen needs through CareVacations @ 877.478.7827.
5 Please bring your own wheelchairs as equipment on the ships is limited.
6 All electric mobility devices must have a gel or dry cell battery.